Since its development, critics of electronic literature have touted all that is “new” about the field, commenting on how these works make revolutionary use of non-linear structure, hyperlinks, and user interaction. Scholars of digital narrative have most often focused their critiques within the paradigms of either the text-centric structuralist model of narrativity or post-structuralist models that implicate the text as fundamentally fluid and dependent upon its reader for meaning. But neither of these approaches can account completely for the unique modes in which digital narratives prompt readerly progression, yet still exist as independent creative artifacts marked by purposive design. I argue that, in both practice and theory, we must approach digital-born narratives as belonging to a third, hybrid paradigm. In contrast to standard critical approaches, I interrogate the presumed “newness” of digital narratives to reveal many aspects of these works that hearken to print predecessors and thus confirm classical narratological theories of structure and authorship. Simultaneously, though, I demonstrate that narrative theory must be revised and expanded to account for some of the innovative techniques inherent to digital-born narrative. Across media formats, theories of narrative beginnings, endings, and authorship contribute to understanding of readerly progress and comprehension. My analysis of Leishman’s electronically animated work Deviant: The Possession of Christian Shaw shows how digital narratives extend theories of narrative beginnings, confirming theoretical suitability of existing rules of notice, expectations for mouseover actions, and the role of institutional and authorial antetexts. My close study of Jackson’s hypertext my body: a Wunderkammer likewise informs scholarship on narrative endings, as my body does not provide a neatly linear plot, and thus does not cleanly correspond to theories of endings that revolve around conceptions of instabilities or tensions. Yet I argue that there is still compelling reason to read for narrative closure, and thus narrative coherence, within this and other digital works. Finally, my inquiry into Pullinger and Joseph’s collaboratively written Flight Paths: A Networked Novel firmly justifies the theory of implied authorship in both print and digital environments and confirms the suitability of this construct to a range of texts.

This doctoral thesis explores the literarity of reportage, with a focus on the 20th century and modern reportage. The aim is to describe the literary strategies used in modern text-based reportage and how these strategies relate to journalistic standards of credibility and ethics. A primary focus is the question of what the reportage is looking for in the literary, what happens to this literarity when it is used for journalistic purposes, and, in turn, how the literary establishes ethics in the text.        By suggesting that a piece of reportage is a journalistic text that simultaneously tells the story about the reporter’s encounter with the event, this dissertation sheds light on possible approaches to the concept of literarity: Subjectivity, narrativity, meta-narrative aspects, the poetic function of language and the performative movements in the text. The ethics of reportage is also to be derived from the encounter, and this thesis implements a concept of ethics in conversations with Emmanuel Levinas and dialogical philosophy. It provides an opportunity to separate ethics from moral, ideological and political dimensions of responsibility in the encounter. This aspect of ethics, where literarity and counter-movement operate beyond the direct intention, is what is needed to understand the reportage genre.      The dissertation also includes six longer reportage analyses embodying its results: Djuna Barnes’s, Vagaries Malicieux, Ryszard Kapuściński’s Another Day of Life, Truman Capote’s In Cold Blood, Hanna Krall’s A Tale for Hollywood, Sven Lindqvist’s Kina nu: Vad skulle Mao ha sagt? and Joan Didion’s, Slouching towards Bethlehem.

Abstract This narrative-biographical study focuses on stories told by teachers working in Lapland about their work and life. The key concept of the study is 'place', which is conceptualised as subjectively experienced place in line with humanistic geography. The research data consisted of interviews of seven teachers working in Lapland, including two Saami and five Finnish teachers. Two main research questions were addressed: I How do teachers tell about place? II What is teachers' manner of knowing from the viewpoint of place? The results revealed an inside view of 'place', which reflects the dweller's perspective towards place. The informants' stories highlighted five place-related sentiments: concern, commitment, sense of home, recognition and appreciation. At the general level, teachers felt concern about the contradiction between the south and the north. They also felt concern about the future of their pupils, schools and villages. Commitment and sense of home were enhanced by a place-related lifestyle and nature as well as an opportunity to do subjectively meaningful things. The teachers described their sentiment of belonging to a place in a way that reflected recognition and appreciation. For an individual, recognition related to everyday phenomena and interpersonal relations played an important role, but recognition by different groups and society was also significant. The autobiographical story by one of the Saami teachers clearly indicated the significance of local knowledge for teachers' work. Personal local knowledge is tacit knowledge based on experience and constitutes an important aspect of teachers' practical knowledge. The focus of this autobiographical story did not involve only the teacher but also the community, the people, the place and the culture that the teacher felt herself to be part of. Saami ancestry defined this teacher's mode of existence in a crucial way. Since she shared the cultural background of her pupils, she understood their everyday school life well. She had an important role as an intermediary at the interface between two cultures. Overall, Finnish teachers work in notably different schools and different conditions. It is important to listen to many different stories, because stories told by marginal actors may serve an emancipatory function for future teachers. Based on the findings, one of the challenges of teacher education is to develop ways of working whereby students can critically evaluate their autobiographical and personal knowledge. Personal experiential background is a valuable resource, which should be taken into account in teacher education already. / Tiivistelmä Tässä narratiivis-elämäkerrallisessa tutkimuksessa tarkastellaan Lapin kouluissa työskentelevien opettajien kertomuksia työstä ja elämästä. Tutkimuksen keskeinen käsite on paikka, joka käsitteellistetään humanistisen maantieteen näkökulmasta koetuksi paikaksi. Tutkimuksen aineistona on seitsemälle Lapissa työskentelevälle opettajalle tehdyt haastattelut. Haastatteluissa on mukana kaksi saamelaista ja viisi suomalaista opettajaa. Päätutkimuskysymyksiä on kaksi: I Millaiseksi opettajat kertovat paikan? II Millainen on opettajan tietämisen tapa paikan näkökulmasta? Tutkimuksen tuloksena syntyi kuva paikasta sisältä päin, sellainen, joka ilmentää asukkaan näkökulmaa paikkaan. Opettajien kertomukset toivat esiin viisi paikkatunnetta: huolen, sitoutumisen, kodintunteen sekä tunnustuksen ja arvostuksen tunteet. Yleisellä tasolla huoli liittyi koettuun vastakkainasetteluun etelän ja pohjoisen välillä. Opettajat tunsivat huolta myös oppilaidensa, koulujensa ja kyliensä tulevaisuudesta. Sitoutumisen ja kodintunnetta vahvistivat paikkaan liittyvä elämäntapa ja luonto sekä mahdollisuus tehdä mielekkäiksi koettuja asioita. Opettajat kuvasivat paikkaan kuulumistaan tavalla, jota voidaan ymmärtää tunnustuksen ja arvostuksen käsitteiden avulla. Tärkeässä osassa yksilön kannalta olivat arkipäivän ilmiöihin ja läheisten ihmisten välisiin suhteisiin liittyvä tunnustus, mutta myös erilaisten ryhmien ja yhteiskunnan taholta tuleva arvonanto. Tutkimuksen tuloksena avautui saamelaisen opettajan minäkertomuksen kautta persoonallisen paikallisen tiedon merkitys opettajan työssä. Persoonallinen paikallinen tieto on kokemukseen perustuvaa, hiljaista tietoa ja muodostaa yhden tärkeän osan opettajan praktista tietoa. Minäkertomuksen keskiössä ei ollut vain kertova opettaja itse, vaan myös yhteisö, toiset ihmiset, paikka ja kulttuuri, joihin opettaja tunsi kuuluvansa. Saamelaisuus määritti opettajana olemisen tapaa keskeisellä tavalla. Koska opettajalla oli samankaltainen kulttuuritausta oppilaidensa kanssa, hän ymmärsi näiden kouluarkea hyvin. Hänellä oli tärkeä, välittävä merkitys toimiessaan koulussa kahden kulttuurin rajapinnalla. Koululaitoksemme opettajat toimivat hyvin erilaisissa kouluissa ja erilaisissa olosuhteissa. Monenlaisten kertomusten kuuleminen on tärkeää, koska marginaaleista esitetyt kertomukset voivat toimia vapauttavina kertomuksina tuleville opettajille. Tutkimuksen tulosten perusteella opettajankoulutukselle voidaan asettaa haasteeksi kehittää työtapoja, joiden avulla opiskelijat voivat arvioida kriittisesti omiin kokemuksiinsa perustuvaa elämäkerrallista ja persoonallista tietoa. Persoonallinen kokemustausta on arvokas resurssi, joka tulisi pystyä ottamaan huomioon jo opettajankoulutusvaiheessa. / Čoahkkáigeassu Dán narratiiva-eallingeardedutkamušas Raija Erkkilä guorahallá Lappileana skuvllaid oahpaheaddjiid muitalusaid barggu ja eallima birra. Dutkamuša guovddáš doaba lea báiki, mii meroštallojuvvo humanisttalaš geografiija geahččanguovllus vásihuvvon báikin. Dutkamuša materiálan leat čieža Lappileanas bargi oahpaheaddji jearahallamat, main leat fárus guokte sápmelaš ja vihtta suopmelaš oahpaheaddji. Váldodutkangažaldagat leat guokte: I Makkárin oahpaheaddjit muitalit báikki? II Makkár lea oahpaheaddji diehtima vuohki báikki geahčcanguovllus? Dutkamuša boađusin šattai govva báikkis siskkobealde, mii čájeha ássi geahččanguovllu báikái. Oahpaheaddjiid muitalusat bukte ovdan vihtta báikedovdamuša: fuolla, čatnaseapmi, ruovttudovdamuš sihke dovddasteami ja árvvusatnima dovddut. Almmolaš dásis fuolla laktásii vásihuvvon vuostegeahčái mátti ja davi gaskkas. Oahpaheaddjit ledje fuolastuvvan maiddái sin oahppiid, skuvllaid ja giliid boahttevuođas. Čatnaseami ja ruovttudovdamuša nannejedje báikái laktáseaddji eallinvuohki ja luondu sihke vejolašvuohta bargat áššiid, maid vásihedje jierpmálažžan. Oahpaheaddjit govvidedje iežaset báikái gullama vugiin, man sáhttá áddet dovddasteami ja árvvusatnima doahpagiiguin. Dehálaš oasis individuála geažil lei dovddasteapmi, mii laktásii árgabeaivvi ihtagiidda ja lagaš olbmuid gaskavuođaide. Dehálaš lei maiddái dovddasteapmi, mii bođii sierralágan joavkkuin ja servodagas. Dutkamuša boađusin rahpasii sápmelaš oahpaheaddji mun-muitalusa bokte persovnnalaš báikkálaš dieđu mearkkašupmi oahpaheaddji barggus. Persovnnalaš báikkálaš diehtu lea vásáhussii vuođđuduvvi jávohis diehtu ja dat duddjo ovtta dehálaš oasi oahpaheaddji praktihkalaš dieđus. Mun-muitalusa guovddážis ii lean dušše muitaleaddji oahpaheaddji ieš, muhto baicca searvvuš, eará olbmot, báiki ja kultuvra, maidda oahpaheaddji dovddai iežas gullat. Sápmelašvuohta mearridii oahpaheaddjin leahkima vuogi guovddáš lági mielde. Go oahpaheaddjis lei seammálágan kulturduogáš iežas oahppiiguin, son áddii bures dáid skuvllaárgga. Sus lei dehálaš, sirdi mearkkašupmi doaimmadettiin skuvllas guovtti kultuvrra rádjedásiin. Min skuvlalágádusa oahpaheaddjit doibmet hui iešguđetlágan skuvllain ja iešguđetlágan diliin. Máđggalágan muitalusaid guldaleapmi lea dehálaš, go marginálain muitaluvvon muitalusat sáhttet doaibmat boahtte oahpaheaddjiide beasti muitalussan. Dutkamuša bohtosiid vuođul oahpaheaddjiskuvlemii sáhttá bidjat hástalussan ovddidit bargovugiid, maid vuođul oahppit sáhttet árvvoštallat kritihkalaččat eallingearddi ja persovnnalaš dieđu, mii vuođđuduvvá sin iežaset vásáhusaide. Persovnnalaš vásihanduogáš lea dehálaš riggodat, man galggašii sáhttit váldit vuhtii juo oahpaheaddjiskuvlenmuttus.

Denna studie är en kritisk diskursanalys av utvalda texter och förpackningar från glassföretagen Järnaglass och Gute Glass. Syftet är att synliggöra hur etiska värden kommuniceras i varumärkeskommunikation och problematisera hur språket kan reproducera social ojämlikhet och föreställningar om etisk konsumtion i en svensk kontext. Studien tar anspråk inom det socialsemiotiska fältet. Tillvägagångsättet har varit att utifrån berättelseanalys samt den multimodala analysen kvalitativt närgranska texternas och förpackningarnas semiotiska resurser. Metoderna synliggör utmärkande värden som företagen väljer att identifiera sig med och diskurser kring etisk glass. Studieresultatet visar att företagen genom varumärkeskommunikation kan skapa identifikation med värden som exempelvis ärlighet, ursprung och framgång. Dessa värden korrelerar med samtida diskurser kring mat som ska betona det personliga, småskaliga och självförverkligande. Utifrån det kritiska perspektivet synliggör studieresultatet att dessa värden och diskurser har möjlighet att reproducera föreställningar och normer om hur konsumenten förväntas agera etiskt och hur vi idag uppnår status. Dessa föreställningar och normer som cementeras genom samtidens varumärkeskommunikation och våra konsumtionsval kan därmed reproducera maktförhållanden som kan bidra till social ojämlikhet i samhället. Slutligen påvisar även studien att samspelet mellan etisk varumärkeskommunikation och människors konsumtionsval kan göra oss passiva i hur vi tar ställning i politiska och miljömässiga utmaningar.

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[ES] En el presente trabajo se estudia la relación de las estrategias narrativas de la música atonal en la ópera de la Escuela de Viena y el cine de la segunda mitad del Siglo XX. Como muestra de la información transmitida en los usos musicales de cada género dramático, se realiza un análisis audiovisual y comparativo de las óperas Erwartung, Wozzeck, Lulú y Moses und Aron junto con las películas Force of evil, The cobweb, Doctor Faustus y The man with the Golden arm. El principal propósito es mostrar las distintas formas en las que se establece la narratividad musical como parte del transcurso histórico del SXX, así como definir la forma en la que afectan al cine y la ópera sus posibilidades y limitaciones dramáticas. / [CA] Al present treball s'estudia la relació de les estratègies narratives de la música atonal a l'òpera de l'Escola de Viena i junt al cinema a la segona meitat del segle XX. Com a mostra de la informació transmesa als usos musicals de cada gènere dramàtic, es realitza un anàlisi audiovisual i comparatiu de les òperes d'Erwartung, Wozzeck, Lulú i Mosses und Aron junt amb les pel·lícules Force of evil, The cobweb, Doctor Faustus i The man with the Golden arm. El principal propòsit es mostrar les distintes formes en les que s'establix la narrativitat musical com a part del transcurs històric del segle XX, així com definir la manera en la que afecten al cinema i l'òpera les seves possibilitats i limitacions dramàtiques. / [EN] This paper will focus on the relationship between the narrative strategies of atonal music in the opera of the Viennesse School and the cinema of the second half of the twentieth Century. By using a sample of the information transmitted in the musical uses of each dramatic genre, an audiovisual and comparative analysis will be made, based on the operas Erwartung, Wozzeck, Lulú and Moses und Aron and the films Force of evil, The cobweb, Doctor Faustus and The man with the Golden arm. The purpose of this analysis is to show the different ways in which musical narrativity is established as part of the historical course of the past century, as well as to define the way in which their dramatic possibilities and limitations affect cinema and opera. / Martín Quintanal, R. (2023). El atonalismo como música incidental: un estudio comparativo sobre la ópera de la Escuela de Viena y el cine de la segunda mitad del Siglo XX [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/195694

Problématique : La pénurie d’organes qui sévit actuellement en transplantation rénale incite les chercheurs et les équipes de transplantation à trouver de nouveaux moyens afin d’en améliorer l’efficacité. Le Groupe de recherche transdisciplinaire sur les prédicteurs du risque immunologique du FRSQ travaille actuellement à mettre en place de nouveaux outils facilitant la quantification du risque immunologique global (RIG) de rejet de chaque receveur en attente d’une transplantation rénale. Le calcul du RIG s’effectuerait en fonction de facteurs scientifiques et quantifiables, soit le biologique, l’immunologique, le clinique et le psychosocial. La détermination précise du RIG pourrait faciliter la personnalisation du traitement immunosuppresseur, mais risquerait aussi d’entraîner des changements à l’actuelle méthode de sélection des patients en vue d’une transplantation. Cette sélection se baserait alors sur des critères quantifiables et scientifiques. L’utilisation de cette méthode de sélection possède plusieurs avantages, dont celui d’améliorer l’efficacité de la transplantation et de personnaliser la thérapie immunosuppressive. Malgré tout, cette approche soulève plusieurs questionnements éthiques à explorer chez les différents intervenants œuvrant en transplantation rénale quant à sa bonne utilisation. Buts de l’étude : Cette recherche vise à étudier les perceptions de néphrologues transplanteurs et référents de la province de Québec face à l’utilisation d’une méthode de sélection des patients basée sur des critères scientifiques et quantifiables issus de la médecine personnalisée. Les résultats pourront contribuer à déterminer la bonne utilisation de cette méthode et à étudier le lien de plus en plus fort entre science et médecine. Méthodes : Des entretiens semi-dirigés combinant l’emploi de courtes vignettes cliniques ont été effectués auprès de 22 néphrologues québécois (transplanteurs et référents) entre juin 2007 à juillet 2008. Le contenu des entretiens fut analysé qualitativement selon la méthode d’analyse de Miles et Huberman. Résultats : Les résultats démontrent une acceptation généralisée de cette approche. La connaissance du RIG pour chaque patient peut améliorer le traitement et la prise en charge post-greffe. Son efficacité serait supérieure à la méthode actuelle. Par contre, la possible exclusion de patients pose un important problème éthique. Cette nouvelle approche doit toutefois être validée scientifiquement et accorder une place au jugement clinique. Conclusions : La médecine personnalisée en transplantation devrait viser le meilleur intérêt du patient. Malgré l’utilisation de données scientifiques et quantifiables dans le calcul du RIG, le jugement clinique doit demeurer en place afin d’aider le médecin à prendre une décision fondée sur les données médicales, son expertise et sa connaissance du patient. Une réflexion éthique approfondie s’avère nécessaire quant à l’exclusion possible de patients et à la résolution de la tension entre l’équité et l’efficacité en transplantation rénale. / Background: The overwhelming scarcity of organs within renal transplantation forces researchers and transplantation teams to seek new ways to increase efficacy. The Groupe de recherche transdisciplinaire sur les prédicteurs du risque immunologique is attempting to put in place a scientifically precise method for determining the global immunological risk (GIR) of rejection for each patient waiting for a renal transplant. The quantification of the GIR is based on scientific factors, such as biological, immunological, clinical and psychosocial. The precise and global determination of the GIR could change the way patients are selected for renal transplantation. This selection will be based thus on scientific and quantifiable criteria. The advantages of the use of this method for selecting potential allograft recipients could be improvement in the efficacy of the process and the individualization of immunosuppressive therapy. In spite of these numerous advantages, this approach raises several ethical questions to explore with nephrologists working in kidney transplantation. Aims of the study: The aims of this study is to explore the views of transplant and referring nephrologists on the use of personalized medicine tools to develop a new method for selection potential recipients of a renal allograft. The results of this research could contribute to determine the acceptable use of this method in renal transplantation and to study the link between science and medicine. Methods: Twenty-two semi-directed interviews, using short clinical vignettes, were conducted with nephrologists in the province of Quebec between June 2007 and July 2008. The semi-directed interviews were analyzed qualitatively using the content and thematic analysis method described by Miles and Huberman. Results: The results demonstrate a general acceptance of this approach amongst the participants. Knowledge of each patient’s immunological risk could improve treatment and the post-graft follow-up. On the other hand, the possibility that patients might be excluded from transplantation poses a significant ethical issue. It could be more effective than the method presently used. The method must be validated scientifically, and must leave a role for clinical judgment. Conclusions: The use of personalized medicine within transplantation must be in the best interests of the patient. However, in spite of the use of such scientific data, a place must be retained for the clinical judgment that allows a physician to make decisions based on medical data, professional expertise and knowledge of the patient. An ethical reflection is necessary in order to focus on the possibility of patients being excluded, as well as on the resolution of the equity/efficacy dilemma.

<p>The study takes its point of departure in the notions of life story, narrativity and context. It is based on extensive life story interviews with well-educated professionals in Poland – academics, teachers, managers, physicians, artists – during the period of transformation (or transition) from ”real socialism” to democracy and a market economy. The aim is to analyse the multilayered process of constructing a personal identity, as the narrators interweave stories about their lives with images of history and society. The central approach is narrative analysis, focusing on the interview interaction as well as the wider cultural, societal and political context in which the self-presentation takes place, and which it simultaneously creates. Concepts of cultural and paradigmatic narratives are combined with a gender perspective and selected terms from Pierre Bourdieus theory of practice. The narrators’ life experiences are shaped and evaluated in an implicit dialogue with cultural narratives of ideal biographies, professional careers, gender roles and family models in Poland during socialism and the transformation. In family background stories, the ancestors’ gendered biographies are depicted in relation to the underlying paradigm of the romantic-patriotic tradition. In childhood stories, the evaluation models used are psychological, social and based on political correctedness. The interviewees often shape their nostalgic, bitter and ambivalent memories against a background of the power relations between the family and the state, using nostalgia, dark rhetorics and a well-established genre of coping strategies during the socialism. In narratives about formal school-education during the socialist period, two paradigms are seen as highly incongruous: the intellectual-elitistic tradition and the socialistic citizen-schooling. Also stories of being a part of both formal and oppositional organisations and networks are told. In narratives about careers and working life, the pride in doing a good work is prevalent, but the narrators also depict complications in the professional paradigm due to the proliferation of politicised and informal power relations; en influence still lasting during the transformation period. The troubled issues of legitimacy, status and economy are discussed. In stories about close relationships, there is an underlying paradigm of love, marrital happiness and being a good parent, even though the stories follow a variety of plots. The evaluations become complex and sometimes contradictory. By presenting their life-experience in a proud, ambivalent, defensive or ironic way, the narrators reproduce, deconstruct and challenge the dominant cultural narratives, shaping their unique personal paradigms.</p>

Historical sources suggest that the bad reputation of Bioko island ―a product of mixed exoticism, fear of death and allure for profit— might have started as early as the first European explorations of sub-Saharan Africa. Today, the same elements seem to have been reconfigured, producing a similar result in the Western imagination: cultural exoticization, fear of state-sponsored violence and allure for profit are as actual as ever in popular conceptions of Equatorial Guinea. A notion of ongoing terror keeps conditioning the study of the tiny African nation, resulting in media trends and academic discourses polarized by the grand themes of oil/money/corruption and human rights violations —which are highly counterproductive when trying to account for Equatoguineans’ everyday practices, mainly because the violence exerted by the state has shifted in nature. Deploying a triple theoretical framework made up by Michel de Certeau’s (1984) concepts of readers/writers/texts and strategies, Michael Jackson’s (2005) work on being, agency and intersubjectivity, as well as Bayart’s (1993) ‘politics of the belly’, this thesis explores some of the complex cultural and social-psychological strategies that urban populations in Malabo have developed in order to create, sustain and protect the integrity of their social selves while living in inherently oppressive environments. People’s means of personhood negotiation are observed through contemporary systems of beliefs, narratives and practices. I suggest that negotiations are products of, but also preconditions for, the existence of a social apparatus and the integrity of the selves moving within its discursive boundaries. Consequently, Equatoguineans’ strategies for self-making are seen as potentially responsible for reproducing a destructive status quo. This idea is further developed through the concept of lateral struggle, a form of social violence alternative to top-down flows which builds on sociality as culturally calibrated forms of symbolic interaction between selves constructed in a zero sum fashion. The dynamics of lateral struggles are illustrated through ethnographic data on what people phrase as el Guineano’s innate ‘rebelliousness’, which in turn visibilizes processes of collective self-making and the verbalization of negative national stereotypes. Possibilities for the rise of more positive types of personhood based on a habitual splitting of individual self from national other are explored. Finally, a brief assessment of how such splitting could be hindering people from collectively writing a ‘homeland’ is made. / Fuentes históricas sugieren que la mala reputación de la isla de Bioko ―producto de una mezcla de exoticismo, miedo a la muerte y deseo de ganacias económicas― pudo haber comenzado desde las primeras exploraciones europeas del África sub-sahariana. Hoy, los mismos elementos parecen haber sido reconfigurados, produciendo un resultado similar en el imaginario occidental: exotización cultural, miedo a la violencia perpetrada por el estado, y deseo de ganancias económicas dada la prominencia de su industria extractiva son elementos importantes en la concepción popular de Guinea Ecuatorial. Una noción de terror prevalente condiciona el estudio de la pequeña nación africana, lo cual resulta en tendencias mediáticas y discursos académicos polarizados por los grandes temas de petróleo/dinero/corrupción y violaciones de derechos humanos ―discursos que resultan contraproducentes a la hora de dar cuenta de las prácticas cotidianas de los Ecuatoguineanos, principalmente porque la violencia ejercida por el estado ha cambiado en lo cualitativo. Haciendo uso de un marco teórico compuesto por los conceptos de lectores/escritores/textos y estrategias desarrollados por Michel de Certeau (1984), el trabajo de Michael Jackson (2005) sobre el ser, la agencia y la intersubjetividad; así como por ‘la política del vientre’ de Bayart (1993), el presente estudio explora algunas de las complejas estrategias culturales y sociopsicológicas que las poblaciones urbanas de Malabo han desarrollado con el fin de crear, mantener y proteger la integridad de su yo social viviendo en ambientes inherentemente opresivos. Los medios utilizados por la gente para el posicionamiento de su yo social son observados mediante sistemas de creencias contemporáneos, narrativas y prácticas. La autora sugiere que dichas negociaciones son productos de, pero también condiciones para, la existencia del aparato social y la integridad de los entes culturales moviéndose dentro de sus fronteras discursivas. En consecuencia, las estrategias que los ecuatoguineanos utilizan para la formación y el mantenimiento de su yo social son consideradas potencialmente responsables de la reproducción de un status quo destructivo. Esta idea es desarrollada mediante el concepto de conflicto lateral ―una forma de violencia social alternativa a flujos ‘top-down’― basado en el principio de la socialidad como una forma culturalmente calibrada de interacción simbólica entre yoes creados como en un juego de suma cero. Las dinámicas de los conflictos laterales son ilustradas mediante material etnográfico sobre lo que la gente denomina “la rebeldía innata del Guineano”, la cual visibiliza además procesos de formación de la identidad colectiva y la verbalización de estereotipos nacionales negativos. Las posibilidades para la creación de identidades individuales más positivas basadas en una diferenciación habitual entre yo-individual y otro-nacional son exploradas. Finalmente, la autora hace un breve comentario sobre cómo dicha diferenciación podría estar impidiendo la formación colectiva de una idea de ‘patria’ en el imaginario ecuatoguineano contemporáneo.

Problématique : La pénurie d’organes qui sévit actuellement en transplantation rénale incite les chercheurs et les équipes de transplantation à trouver de nouveaux moyens afin d’en améliorer l’efficacité. Le Groupe de recherche transdisciplinaire sur les prédicteurs du risque immunologique du FRSQ travaille actuellement à mettre en place de nouveaux outils facilitant la quantification du risque immunologique global (RIG) de rejet de chaque receveur en attente d’une transplantation rénale. Le calcul du RIG s’effectuerait en fonction de facteurs scientifiques et quantifiables, soit le biologique, l’immunologique, le clinique et le psychosocial. La détermination précise du RIG pourrait faciliter la personnalisation du traitement immunosuppresseur, mais risquerait aussi d’entraîner des changements à l’actuelle méthode de sélection des patients en vue d’une transplantation. Cette sélection se baserait alors sur des critères quantifiables et scientifiques. L’utilisation de cette méthode de sélection possède plusieurs avantages, dont celui d’améliorer l’efficacité de la transplantation et de personnaliser la thérapie immunosuppressive. Malgré tout, cette approche soulève plusieurs questionnements éthiques à explorer chez les différents intervenants œuvrant en transplantation rénale quant à sa bonne utilisation. Buts de l’étude : Cette recherche vise à étudier les perceptions de néphrologues transplanteurs et référents de la province de Québec face à l’utilisation d’une méthode de sélection des patients basée sur des critères scientifiques et quantifiables issus de la médecine personnalisée. Les résultats pourront contribuer à déterminer la bonne utilisation de cette méthode et à étudier le lien de plus en plus fort entre science et médecine. Méthodes : Des entretiens semi-dirigés combinant l’emploi de courtes vignettes cliniques ont été effectués auprès de 22 néphrologues québécois (transplanteurs et référents) entre juin 2007 à juillet 2008. Le contenu des entretiens fut analysé qualitativement selon la méthode d’analyse de Miles et Huberman. Résultats : Les résultats démontrent une acceptation généralisée de cette approche. La connaissance du RIG pour chaque patient peut améliorer le traitement et la prise en charge post-greffe. Son efficacité serait supérieure à la méthode actuelle. Par contre, la possible exclusion de patients pose un important problème éthique. Cette nouvelle approche doit toutefois être validée scientifiquement et accorder une place au jugement clinique. Conclusions : La médecine personnalisée en transplantation devrait viser le meilleur intérêt du patient. Malgré l’utilisation de données scientifiques et quantifiables dans le calcul du RIG, le jugement clinique doit demeurer en place afin d’aider le médecin à prendre une décision fondée sur les données médicales, son expertise et sa connaissance du patient. Une réflexion éthique approfondie s’avère nécessaire quant à l’exclusion possible de patients et à la résolution de la tension entre l’équité et l’efficacité en transplantation rénale. / Background: The overwhelming scarcity of organs within renal transplantation forces researchers and transplantation teams to seek new ways to increase efficacy. The Groupe de recherche transdisciplinaire sur les prédicteurs du risque immunologique is attempting to put in place a scientifically precise method for determining the global immunological risk (GIR) of rejection for each patient waiting for a renal transplant. The quantification of the GIR is based on scientific factors, such as biological, immunological, clinical and psychosocial. The precise and global determination of the GIR could change the way patients are selected for renal transplantation. This selection will be based thus on scientific and quantifiable criteria. The advantages of the use of this method for selecting potential allograft recipients could be improvement in the efficacy of the process and the individualization of immunosuppressive therapy. In spite of these numerous advantages, this approach raises several ethical questions to explore with nephrologists working in kidney transplantation. Aims of the study: The aims of this study is to explore the views of transplant and referring nephrologists on the use of personalized medicine tools to develop a new method for selection potential recipients of a renal allograft. The results of this research could contribute to determine the acceptable use of this method in renal transplantation and to study the link between science and medicine. Methods: Twenty-two semi-directed interviews, using short clinical vignettes, were conducted with nephrologists in the province of Quebec between June 2007 and July 2008. The semi-directed interviews were analyzed qualitatively using the content and thematic analysis method described by Miles and Huberman. Results: The results demonstrate a general acceptance of this approach amongst the participants. Knowledge of each patient’s immunological risk could improve treatment and the post-graft follow-up. On the other hand, the possibility that patients might be excluded from transplantation poses a significant ethical issue. It could be more effective than the method presently used. The method must be validated scientifically, and must leave a role for clinical judgment. Conclusions: The use of personalized medicine within transplantation must be in the best interests of the patient. However, in spite of the use of such scientific data, a place must be retained for the clinical judgment that allows a physician to make decisions based on medical data, professional expertise and knowledge of the patient. An ethical reflection is necessary in order to focus on the possibility of patients being excluded, as well as on the resolution of the equity/efficacy dilemma.